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Get MA Attestation for Certificate of Clearance for Renewal 2012

Ts for $50.00 • A legible copy of a government issued identification (ex.: driver’s license) bearing the employee’s photograph and signature. PART I. Employee Information: Full Name______________________________________________________ Social Security #_________________________ Home address __________________________________________________________________________________________ (Street) (City/Town) (State) (Zip Code) Daytime Telephone No. ____________________________ E-mail address_____.

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